Condition
Pulmonary Hypertension
Pulmonary hypertension is high blood pressure in the arteries of the lungs, which makes the right side of the heart work harder and can lead to right heart failure. Iron has the strongest evidence among supplements, moderate, with symptoms improving when low iron was corrected, while small studies of inhaled vasoactive intestinal peptide found lower lung artery pressure and better cardiac output. Most other supplements, such as coenzyme Q10, have only limited evidence.
Sources: PMID 12684393; PMID 18978135
- Supplements studied
- 1
- Medicines and peptides
- 1
- Graded outcomes
- 2
- Trials
- 1
- People studied
- 25
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure Small Improvement | Improves (the measure goes down) | Small effect | 7 studies | 25 people | ||
Studies that measured blood pressure
| ||||||
| Exercise Capacity | Improves (the measure goes up) | 25 people | ||||
Prescription medicines and peptides studied, for context
Vasoactive Intestinal Peptide (VIP/Aviptadil)
- Pulmonary Hemodynamics: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Pulmonary Hemodynamics Petkov 2003: Inhaled VIP reduced pulmonary artery pressure, improved cardiac output and mixed venous oxygen in PAH patients. VIP deficiency found in PAH patient serum and lung tissue. Small clinical studies show promise. | Improves (the measure goes up) | Moderate effect | 7 studies |
Key findings
- Blood PressureImproves (the measure goes down)
The Pulmonary Hypertension Supportive Care protocol
2 primary supplements · 7 supporting supplements
- Coenzyme Q10100–300 mg daily
- IronIV iron if deficient (oral often inadequate); dosing per physician
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Pulmonary Hypertension. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
Fullscript collectionHeart and circulation: evidence-graded picksOpen on Fullscript
The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.
We earn from purchases made in our Fullscript store, and links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Full disclosure
Studies cited
98 studies from PubMed
- Aviptadil Therapy in Acute Respiratory Distress Syndrome Patients: A Systematic Review and Meta-analysis.
- Aviptadil as a Promising Intervention: A Case Study for Transfusion-Related Acute Lung Injury Treatment in a Cardiac Patient.
- Vasoactive Intestinal Polypeptide for Patients Hospitalized With COVID-19 and Hypoxemic Respiratory Failure: Effect on Mortality-The TESICO Trial
- Vasoactive intestinal peptide blockade suppresses tumor growth by regulating macrophage polarization and function in CT26 tumor-bearing mice.
- Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): a randomised, placebo-controlled trial.
- The Use of IV Vasoactive Intestinal Peptide (Aviptadil) in Patients With Critical COVID-19 Respiratory Failure: Results of a 60-Day Randomized Controlled Trial
- Brief Report: Rapid Clinical Recovery From Critical Coronavirus Disease 2019 With Respiratory Failure in a Pregnant Patient Treated With IV Vasoactive Intestinal Peptide.
- The Use of IV Vasoactive Intestinal Peptide (Aviptadil) in Patients With Critical COVID-19 Respiratory Failure: Results of a 60-Day Randomized Controlled Trial.
- Editorial: GPCR in Inflammatory and Cancer Diseases.
- Vasoactive Intestinal Peptide Changes the Frequency and Force of Myocardial Contraction in Rats.
- A Clinical Approach for the Use of VIP Axis in Inflammatory and Autoimmune Diseases
- Vasoactive intestinal peptide increases apoptosis of hepatocellular carcinoma by inhibiting the cAMP/Bcl-xL pathway.
- Erectile dysfunction: a global review of intracavernosal injectables.
- Why drugs fail in clinical trials in pulmonary arterial hypertension, and strategies to succeed in the future.
- Vasoactive Intestinal Peptide (VIP) Nanoparticles for Diagnostics and for Controlled and Targeted Drug Delivery.
- The neuropeptide vasoactive intestinal peptide: direct effects on immune cells and involvement in inflammatory and autoimmune diseases.
- Vasoactive intestinal peptide in pulmonary arterial hypertension.
- Immunomodulation of innate immune responses by vasoactive intestinal peptide (VIP): its therapeutic potential in inflammatory disease
- Genetic association of vasoactive intestinal peptide receptor with rheumatoid arthritis: altered expression and signal in immune cells
- Inhalation of vasoactive intestinal peptide in pulmonary hypertension
- Pulmonary arterial hypertension: on the way to a manageable disease.
- Bioactive analogues and drug delivery systems of vasoactive intestinal peptide (VIP) for the treatment of asthma/COPD.
- [Vasoactive intestinal peptide-producing tumor (ViPoma)].
- Protective effect of vasoactive intestinal peptide on bone destruction in the collagen-induced arthritis model of rheumatoid arthritis
- Vasoactive intestinal peptide modulates proinflammatory mediator synthesis in osteoarthritic and rheumatoid synovial cells
- The significance of vasoactive intestinal peptide in immunomodulation.
- Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension
- Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension.
- Vasoactive intestinal peptide in the immune system: potential therapeutic role in inflammatory and autoimmune diseases.
- Immunoeffector and immunoregulatory activities of vasoactive intestinal peptide.
- Vasoactive intestinal peptide prevents experimental arthritis by downregulating both autoimmune and inflammatory components of the disease
- Immunobiology of vasoactive intestinal peptide (VIP).
- Vasoactive intestinal peptide mediation of development and functions of T lymphocytes.
- Vasoactive intestinal peptide neurons as synaptic targets for vasopressin neurons in the suprachiasmatic nucleus. Double-label immunocytochemical demonstration in the rat.
- Selectivity of effects of vasoactive intestinal peptide on macrophages and lymphocytes in compartmental immune responses.
- Expression of mRNA for vasoactive intestinal peptide in normal human colon and during inflammation.
- Oral sodium regulates extrahepatic metabolism of vasoactive intestinal peptide.
- Molecular characteristics of the cellular receptor for vasoactive intestinal peptide.
- Vasoactive intestinal peptide. Messenger in a neuroimmune axis.
- Vasoactive intestinal peptide (VIP): an amnestic neuropeptide.
- Vasoactive intestinal peptide (VIP), a putative neurotransmitter of nonadrenergic, noncholinergic (NANC) inhibitory innervation and its relevance to therapy.
- Vasoactive intestinal polypeptide and asthma.
- Vasoactive intestinal peptide and asthma.
- [Vasoactive intestinal peptide and substance P in the regulation of reproductive functions].
- Vasoactive intestinal peptide as a mediator of intercellular communication in the cerebral cortex. Release, receptors, actions, and interactions with norepinephrine.
- Vasoactive intestinal peptide as a modulator of lymphocyte and immune function.
- The role of vasoactive intestinal peptide and other neuropeptides in the regulation of the immune response in vitro and in vivo.
- Vasoactive intestinal peptide secreting tumors. Pathophysiological and clinical correlations.
- Vasoactive intestinal peptide in the lung.
- Vasoactive intestinal peptide as a coronary vasodilator.
- Pulmonary clearance of vasoactive intestinal peptide.
- l-Citrulline supplementation improves O2 uptake kinetics and high-intensity exercise performance in humans
- Vasoactive peptides in the lung, with special reference to vasoactive intestinal peptide.
- Vasoactive intestinal peptide (VIP).
- Effects of supplemental citrulline malate ingestion during repeated bouts of lower-body exercise in advanced weightlifters
- The Effect of Citrulline/Malate on Blood Lactate Levels in Intensive Exercise
- Citrulline Malate Fails to Improve German Volume Training Performance in Healthy Young Men and Women
- L-citrulline reduces time to exhaustion and insulin response to a graded exercise test
- Effects of Supplemental Citrulline-Malate Ingestion on Blood Lactate, Cardiovascular Dynamics, and Resistance Exercise Performance in Trained Males
- Effects of Citrulline Malate and Beetroot Juice Supplementation on Blood Flow, Energy Metabolism, and Performance During Maximum Effort Leg Extension Exercise
- Eight weeks of resistance training in conjunction with glutathione and L-Citrulline supplementation increases lean mass and has no adverse effects on blood clinical safety markers in resistance-trained males
- Citrulline/malate promotes aerobic energy production in human exercising muscle
- Citrulline malate enhances athletic anaerobic performance and relieves muscle soreness
- Acute Effect of Citrulline Malate Supplementation on Upper-Body Resistance Exercise Performance in Recreationally Resistance-Trained Men
- Acute citrulline malate supplementation improves upper- and lower-body submaximal weightlifting exercise performance in resistance-trained females
- Acute Effects of Citrulline Supplementation on High-Intensity Strength and Power Performance: A Systematic Review and Meta-Analysis
- Acute citrulline-malate supplementation improves maximal strength and anaerobic power in female, masters athletes tennis players
- Impact of L-citrulline supplementation and whole-body vibration training on arterial stiffness and leg muscle function in obese postmenopausal women with high blood pressure
- Impact of l-citrulline supplementation on oxygen uptake kinetics during walking
- Effects of L-citrulline oral supplementation on polymorphonuclear neutrophils oxidative burst and nitric oxide production after exercise
- Oral L-citrulline supplementation enhances cycling time trial performance in healthy trained men: Double-blind randomized placebo-controlled 2-way crossover study
- Acute citrulline-malate supplementation is ineffective during aerobic cycling and subsequent anaerobic performance in recreationally active males
- One Week of L-Citrulline Supplementation Improves Performance in Trained Cyclists
- Oral L-citrulline supplementation attenuates blood pressure response to cold pressor test in young men
- The effects of short term L-citrulline supplementation on wave reflection responses to cold exposure with concurrent isometric exercise
- l-Citrulline supplementation attenuates blood pressure, wave reflection and arterial stiffness responses to metaboreflex and cold stress in overweight men
- Does l-citrulline supplementation improve exercise blood flow in older adults?
- Effect of oral L-citrulline on brachial and aortic blood pressure defined by resting status: evidence from randomized controlled trials
- Acute effects of Nitrosigine® and citrulline malate on vasodilation in young adults
- Acute Citrulline-Malate Supplementation and High-Intensity Cycling Performance
- Oxidative stress and nitrate/nitrite (NOx) status following citrulline supplementation in type 2 diabetes: a randomised, double-blind, placebo-controlled trial
- Improvement of ventricular function in systolic heart failure patients with oral L-citrulline supplementation
- Effect of L-arginine or L-citrulline oral supplementation on blood pressure and right ventricular function in heart failure patients with preserved ejection fraction
- Effect of citrulline on post-exercise rating of perceived exertion, muscle soreness, and blood lactate levels: A systematic review and meta-analysis.
- Citrulline Malate Does Not Improve Muscle Recovery after Resistance Exercise in Untrained Young Adult Men
- L-citrulline improves splanchnic perfusion and reduces gut injury during exercise
- Short-term effects of L-citrulline supplementation on arterial stiffness in middle-aged men
- Inter-Individual Responses to Citrulline Malate Oral Supplementation on Post-Exercise Hypotension in Hypertensives: A 24-Hour Analysis
- Acute Effects of Citrulline Malate Supplementation on Nocturnal Blood Pressure Dipping After Exercise in Hypertensive Patients: A Randomized, Placebo-Controlled Trial.
- L-Citrulline increases nitric oxide and improves control in obese asthmatics
- Chronic l-citrulline supplementation improves cardiac sympathovagal balance in obese postmenopausal women: A preliminary report
- Inflammatory markers response to citrulline supplementation in patients with non-alcoholic fatty liver disease: a randomized, double blind, placebo-controlled, clinical trial
- Oral l-citrulline malate in patients with idiopathic pulmonary arterial hypertension and Eisenmenger Syndrome: a clinical trial
- L-citrulline-malate influence over branched chain amino acid utilization during exercise
- Dose-ranging effects of citrulline administration on plasma amino acids and hormonal patterns in healthy subjects: the Citrudose pharmacokinetic study
- Oral citrulline does not affect whole body protein metabolism in healthy human volunteers: results of a prospective, randomized, double-blind, cross-over study
- Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction
- Nitric oxide precursors and congenital heart surgery: a randomized controlled trial of oral citrulline